1979, 11-26 Permit: 79-8290 Wood Stove PLAN NUMBER APPLICATION/PERMIT PERMIT NUMBER (
SPOKANE COUNTY — BUILDING CODES DEPARTMENT 7q- 89C)
NORTH 811 JEFFERSON / SPOKANE,WASHINGTON 99260 / (509) 456-3675 DATE //—A4`79
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 4 COPIES
JOB ADDRESS
LEGAL DESCRIPTION — SEE ATTACHED
1. / • / .t •n,J`K_ it
LOT BLOCK I3I 10 PARCEL NUMPER/S 7 D G
Z OwAIER PHONE 7446
3. �d.4 -i j r r ,2e,/7yf p D
ADDRESS � ZIP Required Set Backs in Feet f �t/� J(
j' ,f/. .�`> ''/.Z a-SA� ���� � North (South (East 'West 7,OCJ Cf(
CONTRACTOR PHONE Size of Parcel Zone Classification
4. `\i/� �i
A DRESS ZIP Type Const. Occupancy Sprinklered ;��6
�,/I/L1-,d ❑Yes ❑No ❑ Req'd. a
DESIGNER PHONE Valuation Building Area in Sq. Ft.
5. ADDRESS ZIP DWL Area 'Basement Area Garage Area I Storage
CHANGE OF USE FROM TO Split Entry Split Level Rancher
6.
No. Baths No. Floors No. Rooms Rec. Room
TYPE ❑ NEW ❑ ALT. ❑ AD'N. ❑ RPL. ❑ MVE.
7. OF ❑ OTHER -
WORK ❑ BLD. ❑ PLMB. M MECH: ❑ M.H. ❑ POOL CERTIFICATE Req'd. Rec'd. Not Req'd.
of EXEMPTION
SCRIBE WORK / FEES COLLECTED
8. 1/1 ‘t-ti(.� .-Z1 J. .L�)-2^ '! 4-1,1;4-4-t.;> '
VALUATION Soce GAS ELECII-RIC'y WATER SEWER
of
9. Utilities
Single $
—
I hereby certify that I have read and examined this application and have read the "NOTICE" provisions included
on reverse side, and know the same to be true and correct. All provisions of laws and ordinances governing this Building
type of work will be complied with whether specified herein or not. The granting of a permit does not presume
to give authority to violate or cancel the provisions of any other state or loc law regulating construction or the
performance of construction. ..-- Plumbing
DATE /1—4:1.'..•42 " -71 SIGNATURE !""�" 74-e-e-k4;6-e-x-----` Mech. 7'"--
SPECIAL APPROVALS SPECIAL CONDITIONS:
DEPT. REQ'D. REC'D. Plan Check
Env.Health o_
SEPA I-
r--
U
Planning _ w
d
Mobile Home cn
Fire Marshall z—
Co. Engineer Other (Specify)
Utilities
TOTAL $f7 G�
.
Zone Clearance
WHEN MACHINE VALIDATED IN THIS SPACE,
SEPA Checklist //_.2e-_ 7'? THIS BECOMES A PERMIT.
11 --26 -79 829.05 * 7.00 ° i-
DATE OFFICIAI
APPROVED FOR ISSUANCE _